Cardiac Magnetic Resonance Imaging Findings in 2954 COVID-19 Adult Survivors: A Comprehensive Systematic Review.

Abstract

BackgroundRecent studies have utilized MRI to determine the extent to which COVID‐19 survivors may experience cardiac sequels after recovery.PurposeTo systematically review the main cardiac MRI findings in COVID‐19 adult survivors.Study typeSystematic review.SubjectsA total of 2954 COVID‐19 adult survivors from 16 studies.Field Strength/sequenceLate gadolinium enhancement (LGE), parametric mapping (T1‐native, T2, T1‐post (extracellular volume fraction [ECV]), T2‐weighted sequences (myocardium/pericardium), at 1.5 T and 3 T.AssessmentA systematic search was performed on PubMed, Embase, and Google scholar databases using Boolean operators and the relevant key terms covering COVID‐19, cardiac injury, CMR, and follow‐up. MRI data, including (if available) T1, T2, extra cellular volume, presence of myocardial or pericardial late gadolinium enhancement (LGE) and left and right ventricular ejection fraction were extracted.Statistical TestsThe main results of the included studies are summarized. No additional statistical analysis was performed.ResultsOf 1601 articles retrieved from the initial search, 12 cohorts and 10 case series met our eligibility criteria. The rate of raised T1 in COVID‐19 adult survivors varied across studies from 0% to 73%. Raised T2 was detected in none of patients in 4 out of 15 studies, and in the remaining studies, its rate ranged from 2% to 60%. In most studies, LGE (myocardial or pericardial) was observed in COVID‐19 survivors, the rate ranging from 4% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in “healthy” controls. Most studies found that patients who recovered from COVID‐19 had a significantly greater T1 and T2 compared to participants in the corresponding control group.Data ConclusionFindings of MRI studies suggest the presence of myocardial and pericardial involvement in a notable number of patients recovered from COVID‐19.Level of Evidence3Technical Efficacy Stage3